National Indigenous Peoples Day: Talking to our Children

Dr. Jo Ann Unger receives teaching from Grandmother Pahan Pte San Win, May 17th, 2021

June is National Indigenous History Month, and June 21st is National Indigenous Peoples Day in Canada.  This day was first declared in 1996 by then Governor General of Canada, Roméo LeBlanc, as National Aboriginal Day, later changed to National Indigenous Peoples Day in 2017 by Prime Minister Justin Trudeau.  The purpose of the day is for all Canadians to recognize and celebrate the unique heritage, diverse cultures and outstanding contributions of First Nations, Inuit and Métis peoples.  The purpose of National Indigenous History Month is for all Canadians to learn about, appreciate and acknowledge the contributions First Nations, Inuit and Métis people have made in shaping Canada. However, to truly understand and appreciate these contributions, Canadians need to also learn about and acknowledge the harms that were committed against Indigenous peoples in this country.  And as we have recently seen by the terrible discoveries in Kamloops, British Columbia, more and more is coming to light about the harms that were committed.

Call to Action number 62 from the Truth and Reconciliation Commission of Canada calls on all levels of government, in consultation and collaboration with Survivors, Aboriginal peoples, and educators, to make age-appropriate curriculum on residential schools, Treaties, and Aboriginal peoples’ historical and contemporary contributions to Canada a mandatory education requirement for Kindergarten to Grade 12 students.  There can be no truth and reconciliation without really hearing, learning about and uncovering the truth.  Part of our road to reconciliation is to hear the stories and learn the full history of how our country was created. This history is dark and involves violence, abuse, oppression and colonization towards adults and children who were native to this land.  Parents and caregivers of young children may have questions about how to honestly share this information with their children in an age-appropriate way.

To support this important work, we passed tobacco to Grandmother Pahan Pte San Win to share her wisdom and advice on this topic. Grandmother Pahan currently works with children in various school divisions in Winnipeg and is the Grandmother for a number of organizations such as Full Circle for Indigenous Education and Louis Riel School Division.  She is also a registered social worker and has provided counselling support to residential school survivors and traumatized women and spiritual care to incarcerated youth and men.  With over 27 years of experience as a therapist to residential school survivors and having survivors within her family, Grandmother Pahan has an intimate connection to the history of residential schools in this country.  Grandmother Pahan is Lakota, Cree and Métis with roots that reach back to Wood Mountain, Saskatchewan and Yellowknife Northwest Territories.

In response to our question of how to talk to young children about Canada’s history, Grandmother Pahan told this story:

“Every year, September 30th is Orange Shirt Day, and this year my granddaughter Natalie is in Grade 1.  For the last couple of years, when I bought myself an orange shirt for Orange Shirt Day, I thought, ‘I should get one for Natalie.’  Natalie has a little brother, who is just tiny. You can’t get a shirt for one of your grandchildren unless you get one for the other. And then I had to get one for their mother, and it turned into getting one for everybody.  It was really fun and exciting.  Each year, I made sure I got the shirts to them before September 30th even though, last year, she was only in Kindergarten and probably didn’t know much about it.

In 2019, my husband says to me, like he does, ‘They asked us to come over there.  I think they are going to feed us breakfast.’ 

And I say, ‘Well, where is over there?’ 

And he says, ‘Oh, you know, over there at NCTR.’ 

‘Oh, okay,” I think, ‘They are going to feed us breakfast at the National Centre for Truth and Reconciliation.  My husband sits on the NCTR Survivor Council, so that kind of made sense, but I did not know what it was about.  We drive over there and I notice there are people in the parking lot.  I go into the centre and look around.  I see that it is not like my husband said.  It is a press conference.  Yes, there was going to be some food after, probably, but people were gathered, dressed nicely, for a press conference. 

I think, ‘Okay, something is happening, but I’m not sure what it is.’ I go and look around and visit with some people.  Then I go and sit in the front row because I’m a tiny person and I can’t see unless I sit there.  I love sitting in the front row.  I’m sitting in the front row and this nice lady comes and sits down beside me.  She is wearing an orange shirt.  I hadn’t seen that kind of shirt before.  There are different versions of the orange shirt.  I say to her, ‘I really like your orange shirt.’  She tells me where she got it and I find out she’s from B.C.  Then the conversation ends and I was quiet for a few minutes.  Then I turn to her and say, ‘Are you speaking here today?’ 

And she said, ‘Yes.’

I start to figure it out and say, ‘That woman who went to residential school with an orange shirt and had it taken from her, are you one of her relatives?’ 

She says, ‘No, it was me.”  Her name is Phyllis Jack Webstad and they were launching Orange Shirt day from the National Centre for Truth and Reconciliation.  And I thought about that and thought about Phyllis’ grandmother and Phyllis.  The woman sitting beside me is my age and, in my mind, I thought Phyllis was older and had maybe passed away already.  I thought the woman sitting beside me would have been her daughter or granddaughter.  But no, it was Phyllis.  Then I thought about her grandmother.  She also went to residential school and when she bought that orange shirt for Phyllis, she must have known what would happen when she got there.  Then Phyllis got up, talked and said some wonderful things. I learned a lot that day. 

This was just before September 30th, so I had new shirts for my little Natalie, her brother and the family. I made my delivery before September 30th.  On the morning of the 30th, I got up and put on my orange shirt.  I started thinking about Natalie because I was going to a school to do a presentation about Orange Shirt Day.  I was part of what they were learning about that day.  As I looked in the mirror, at this wonderful orange shirt, I thought, ‘Oh, now it’s my turn. I’m the grandmother and I’m the one who bought the shirt for my granddaughter.”  In that moment, it just hit me really hard and I thought how completely I adore Natalie.  She is like the sunshine in the family.  I had a moment where I thought, ‘This must be what it would feel like to be giving that orange shirt when you know that they are going to residential school.’  That was a powerful moment for me to connect to Orange Shirt Day; and to connect to Phyllis, her grandmother, and to all parents and grandparents who treasure their children. 

We all want to protect our children from anything that could ever hurt or disrupt anything with them.  We all want that.  And yet we know that for many parents and grandparents, that is not what happened.  Orange Shirt Day is a fun way to get to buy an orange shirt for my granddaughter.  But it is also the introduction to her about something that happened before that was not good.  And for Grade1, Natalie just knows that we wear these orange shirts because a little girl like her, when she went to school for the first time, had her orange shirt taken from her and didn’t like that.  Natalie can relate to that.  Next year, when she is in Grade 2, she will learn a little bit more about that story.  Each year, as they get older, we will tell a little bit more of the story. 

In our communities, residential school is like the Holocaust.  It decimated families. It robbed us of our parenting skills and it destroyed the fabric; the way that our families and communities were knitted together through kinship.  It tore all of those things away.  And that’s what we’re rebuilding. 

I appreciate what you are doing in wanting to educate and wanting to support parents to educate their children because we want you to know what our experience has been.  If you don’t know what our experience has been, you won’t be able to find the depth of compassion that we require when you see all of the different ways that our families and communities have responded to that.

But everyone can relate to the loss of a child, how devastating that is and also how precious children are.  When the Truth and Reconciliation Commission made their 94 recommendations, some of the recommendations were about education in the school because we know that’s where it starts.  Children naturally have compassion.  They have a sense of justice and what’s not just.  We don’t even have to teach them that.  They feel it.  It’s inside their heart.  Our job is helping them to know, gently, a little bit at a time, that things happened that weren’t just, that people were wronged and harmed, and still hurt today because of it.  All of that starts with children.

Not that we are giving up on adults.  Adults have to do their work too.  But in a generation, we won’t have adults who need to do work because they will have been educated about things that happened that were wrong and that it isn’t over.  Residential schools are closed but people continue to be affected by it.  And systemic racism is still something our people face. We hope that adults will do their work; to see how they contribute to holding the status quo so that the wrongs cannot be righted.  And then to ask how they can raise their children so that they will already know that things happened that were wrong. Maybe they can come to say, ‘Let’s make sure we get it right now and do things differently.’  And then asking, ‘What else do I need to do to dismantle the systemic racism that is still in place and holding people back from what would be equitable and fair so that communities can thrive?’  That’s what we want.  We want to be able to thrive just like you want your children to thrive like you want all the children in schools to thrive.  We want our children to thrive as well.  That’s what we’re working on.” 

As parents, our instinct may be to protect our children from experiencing the difficult emotions that come from learning about residential schools and systemic racism.  And because of this, we may be hesitant to teach our children about these issues. We asked Grandmother Pahan her thoughts about this as well.

“I think it would be wise to protect them from them learning from somebody else that wouldn’t teach them in the way that you would want them to learn.  Get there first and make sure that it is age-appropriate.  We do that with everything; how much we tell them about sex, how much we tell them about illness and death.  We still need to talk about it, but we tell them different information based on how old they are.  And if you are not sure about that, it is good to reach out to someone who feels more clear about it.  Be careful you are not protecting yourself by not talking about it because it is not comfortable or having your own reasons about why it is hard for you to talk about it.

Protect them by telling them in a way that you think is the best for your child rather than how they are going to hear about it from other kids or someone who isn’t so careful.”

To support you in having these conversations with your child, as we learn more about the atrocities that took place in residential schools and as we approach June 21st, National Indigenous Peoples Day, we have provided you with some additional resources, which include materials for various age groups.

Additional Resources for Families

Full Circle for Indigenous Education:  https://fullcircleindigenous.ca/

“It is our intention to support learning in regard to Jahistory, culture, language, Indigenous pedagogy and Indigenous Ways of Knowing and Being. Through that learning, the growth of the whole person is supported, and the full story of our shared history is acknowledged. Within that growth, we move closer to reclaiming lost aspects of self, family, community and healthy relationships with ourselves and all that surrounds.”

Among many resources, this organization provides a list of recommended books for early readers.  https://fullcircleindigenous.ca/early-years-books/

National Centre for Truth and Reconciliation:  https://nctr.ca/

A part of our mandate at the National Centre for Truth and Reconciliation (NCTR) is to raise awareness of the history and creation of the residential school system, its ongoing legacy, and how it has shaped the country we live in today. The teaching resources and educational programming we offer make it easier for the public to learn the truth about this tragic history.”

A wide variety of resources, including books, activities and videos, for various age groups are listed on the NCTR Education page.

Government of Canada Resources:

https://www.rcaanc-cirnac.gc.ca/eng/1100100013248/1534872397533

More information on National Indigenous Peoples Day

https://www.rcaanc-cirnac.gc.ca/eng/1559222623218/1559222644174

More information on National Indigenous History Month

https://www.rcaanc-cirnac.gc.ca/eng/1496255894592/1557840487211

#IndigenousReads recommended reading list for various age groups.

https://www.rcaanc-cirnac.gc.ca/eng/1528210353182/1580759773150

Celebrating Indigenous Peoples in Canada: Learning and activity guide

Truth and Reconciliation Commission of Canada: Calls to Action

http://trc.ca/assets/pdf/Calls_to_Action_English2.pdf

Interview by Dr. Jo Ann Unger

MORE COMMON THAN YOU THINK

There Is Hope The good news is that mental illness can be treated effectively. There are things that can be done to prevent mental illness and its impact and help improve the lives of children experiencing mental health concerns. Early intervention is best.

How KIDTHINK Can Help 

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Tips on Co-Parenting to Support Children’s Mental Health

 

The old adage “it takes a village to raise a child” holds true for many families in our society. But what happens when that village breaks up or divides? Research shows us that children of parents who separate or divorce are at greater risk of having emotional, adjustment, mental health, relational and life satisfaction issues well into adulthood (Radetzki et al., 2020). How does this happen?

Children’s brains continue to develop new connections on a daily basis. In fact, the human brain does not reach its full maturity until well into our third decade of life (Sowell et al., 1999) and some researchers have challenged whether the brain ever stops maturing (Somerville, 2016). This means that every situation, event, or experience impacts the developing brain connections in any child at any moment in time.

Statistics of separation or divorce are approximately 50% for any relationship. When parents decide to separate or divorce, this event can impact the child’s brain development in unintended ways. Since the child’s brain is continuously growing new connections, exposure to high conflict can result in a child who has a poorer relationship with their parent(s), which results in poorer emotional resilience during stressful life events and increased difficulties nurturing healthy bonds with others (Huppert, 2009).

Children who experience a typical parental divorce are more prone to unhappiness, anxiety, depression, and overall poorer life satisfaction (Radetzki et al., 2020). Children who experience a highly conflicted parental divorce are at risk of behavioural problems, poorer performance at school, lower emotional well-being and security, and increased vulnerability to future depression and substance abuse. Some ways to buffer against these outcomes and disruptions to attachment security, common in divorce and separation, include parents providing space for children to express their feelings openly and allowing children to have their own feelings separate of those of their parents.

When parents are openly angry and resentful towards each other during the separation or divorce, children become secretly injured by the shrapnel. In other words, children who witness such animosity between parents are more likely to experience their own adjustment issues such as problems with anger, resentment, anxiety and guilt (Wiidanen, 2020).

How Can Co-Parents Reduce the Risk of Negative Outcomes in Children of Separation or Divorce? (Nunes et al, 2020)

  1. Focus on the child’s needs:
    Children who maintain healthy relationships with each parent are less likely to develop long-term mental health issues related to attachment problems.
  2. Become more self-aware (e.g., body cues, tone of voice, language):
    Notice how you communicate in front of your child about the other parent. The child’s emotional well-being gets chipped away by a parent’s negative commentary regarding the other parent. Pay attention to your visible emotional reactions when feeling ‘triggered’ by the other parent. These outward emotional explosions negatively impact the child, even if it doesn’t appear as such.
  3. Learn specific coping skills to deal with emotions of separation/divorce: Find a counsellor or a therapist who can help you process your emotions related to the separation or divorce. Learn cognitive behavioural therapy techniques to challenge irrational thoughts. Practice mindfulness meditation to bring your attention to the present moment. Get proper sleep, eat healthy foods and get some exercise three to five times per week.
  4. Learn how to communicate more effectively together with the co-parent: When parents are angry and resentful with each other, the style of communication can become destructive. Remember that the goal of co-parenting is to focus on the needs of the child. Communicating in constructive ways will not only reduce the emotional negativity between the parents, but it will reduce the negative long-term consequences to the child’s mental well-being.
  5. Create a Co-Parenting Plan:
    Understanding each other’s clear expectations in shared parenting roles, responsibilities and tasks is achieved by communicating clearly and constructively. When a well-defined co-parenting plan is developed, it can greatly reduce future misunderstandings and conflict.

It can “take a village to raise a child,” which is why having both parents involved in a child’s life, where possible, is ideal. If separating/divorcing parents are noticing concerns about their child’s behaviours, emotional regulation or mood, please contact KIDTHINK to learn how you can access supports during a difficult time to maximize the mental health of the child for the long haul.

Written by Tamara Rogers, MSc., BMR (OT), OT Reg. (MB),
Outreach Clinician

More Common Than You Think:  

There Is Hope 

The good news is that mental illness can be treated effectively. There are things that can be done to prevent mental illness and its impact and help improve the lives of children experiencing mental health concerns. Early intervention is best.  

How KIDTHINK Can Help:   

To make a referral contact us   

For additional resources   

 Subscribe to our newsletter

References

Huppert, F. (2009). Psychological well-being: evidence regarding its causes and consequences. Applied Psychology: Health and Well-Being, 1(2), 137-164. https://doi.org/10.1111/j.1758-0854.2009.01008.x

Nunes, C., de Roten, Y., Ghaziri, N. (2020). Co-parenting programs: a systematic review and meta-analysis. Family Relations Interdisciplinary Journal of Applied Family Science, https://doi.org/10.1111/fare.12438

Somerville, L. (2016). Searching for signatures of brain maturity: what are we searching for? Neuron: Neuroview; 92(6),1164-1167. https://doi.org/10.1016/j.neuron.2016.10.059

Sowell ER, Thompson PM, Holmes CJ, et al. In vivo evidence for post-adolescent brain maturation in frontal and striatal regions. Nature Neurosci. 1999; 2:859–61.

Radetzki, P., Deleurme, K. and Rogers, S. (2020). The implications of high-conflict divorce on adult-children: five factors related to well-being. Journal of Family Studies. https://www.tandfonline.com/doi/full/10.1080/13229400.2020.1754277

Wiidanen, K. “Centering Children in Co-Parenting” (2020). University Honors Theses. Paper 870. https://doi.org/10.15760/honors.891

ADHD in Children

Children can be hyperactive, impulsive, and inattentive. Children can run around playing, climb on things to seek adventure, and seem to never stop talking about their exciting day. They can interrupt often, blurt out their great ideas, and seem impatient waiting for their turn. They can also be disorganized, lose things, get distracted, and seem like they are not listening to anything they are told. These behaviours are common and may even be some of the things most loved about some children.  However, these behaviours can also be problematic and raise concerns if they occur beyond what is expected for their age and if they result in negative consequences during their daily lives, like their school performance or friendships.  In these cases, these behaviours may be indicative of something more going on, such as an underlying disorder. 

Attention-Deficit/Hyperactivity Disorder, or ADHD, is a neurodevelopmental disorder that involves more than usual levels of inattention, impulsivity, and hyperactivity that interfere with school, social, and home functioning (APA, 2013). It is one of the most commonly diagnosed neurodevelopmental disorders in Canada, affecting approximately 5% of children worldwide (CADDAC, 2021). It is highly heritable, and symptoms emerge in childhood and tend to last a lifetime. In fact, more than 75% of children diagnosed with ADHD continue to experience significant symptoms into adulthood, although they might change over time (CDC, 2020). Children with ADHD are at risk for other challenges and many also have co-occurring disorders like learning disabilities or disruptive behavioural disorders; however, there are treatments available and KIDTHINK can help. 

 

Diagnosis, Symptoms, and Subtypes

Professionals use the Diagnostic Manual of Mental Disorders -5th Edition (DSM-5) to diagnose ADHD and it lists three types of ADHD presentations, relying on three core symptoms (inattention, hyperactivity, and impulsivity): 

The subtype of diagnosis depends on the number of symptoms present in the individual. Some children may only show inattentive symptoms, and some may only show hyperactive-impulsive symptoms, but the majority show both. For a diagnosis, symptoms of ADHD must arise in early childhood (prior to the age of 12) but can change presentation throughout their development.  Symptoms must be present for at least 6 months, be more than what is expected for their age, and be present in more than one setting, such as home and school (APA, 2013).

There is no single test or tool to diagnose ADHD, and diagnosing it is a comprehensive process which generally takes several steps. It typically involves ruling out other problems that have similar symptoms (e.g., hearing problems, sleep difficulties, learning disabilities, trauma or anxiety), gathering a thorough history of the child from multiple sources, and completing a clinical evaluation of the child’s social, academic, cognitive, emotional, and developmental functioning.  

 

What is the difference between ADHD and ADD?

The labels ADHD and ADD (Attention-Deficit Disorder) are confusing because the name of the disorder has changed over time. Prior to the DSM-5, older editions of the manual used the term ADD, but now ADD is called ADHD, regardless of whether symptoms of hyperactivity and impulsivity are present. Despite the official change of labels, many professionals and individuals still choose to use both terms, perhaps out of habit, or to describe children who have ADHD but are not hyperactive and impulsive. Currently, children who are inattentive but not hyperactive or impulsive will receive a diagnosis of ADHD (APA, 2013). 

 

What is the treatment for ADHD?

While there is no cure for ADHD, it is often referred to as the most treatable mental health condition (CADDAC, 2021). The right treatments can help reduce symptoms and improve functioning by supporting you and your child. Treatment for ADHD should be multifaceted and standard treatments for ADHD include medical, educational, behavioural, and psychological components. Depending on your child’s needs, age and severity of symptoms, their treatment plan may include parent skills training and counselling, medication, behavioural training, cognitive behavioural therapy, social skills training, psychotherapy, family therapy, classroom intervention, and psychoeducation (CHADD, 2021).

 

Does my child need treatment?

Symptoms of ADHD commonly interfere with children’s school, social, and home functioning. Children with ADHD may have more difficulties with academics, friendships, extra-curricular activities, and family relationships. For example, they may lose friends because they are constantly interrupting and in other’s faces, or they may get kicked off the sports team because they struggle following rules. They may also display more behavioural challenges such as defiance, tantrums, and arguing than peers their same age. When left untreated, children with ADHD are at greater risk for several issues, including learning difficulties, school dropout, additional mental health disorders, lower self-esteem, and substance abuse. The good news is that with proper diagnosis, treatment and support, children with ADHD can be successful and happy, and live meaningful lives (CADDAC, 2021). 

 

What do I do if I think my child has ADHD?

If you think your child has ADHD, a common first step is to take your child to a pediatrician to rule out other possible medical causes that have symptoms similar to ADHD. For example, a child with hearing problems may present as a child who does not follow through on tasks, does not follow directions, and interrupts or intrudes on others. Once medical problems are ruled out, a common second step is for the child to undergo a clinical evaluation, like a psychological assessment, that will include a careful and thorough history and evaluation of the child’s academic, social, emotional, and developmental functioning through questionnaires and standardized tests. Clinical psychologists typically complete these assessments and will diagnosis if ADHD and/or other disorders are present. ADHD is also commonly diagnosed by psychiatrists. 

 

How can KIDTHINK help?

KIDTHINK clinical psychologists can help you decide if your child would benefit from an assessment to determine whether ADHD or other underlying problems are present. If your child has a diagnosis of ADHD, KIDTHINK professionals, including mental health clinicians, outreach clinicians, and clinical psychologists will determine and implement appropriate intervention supports for your child. KIDTHINK also has a psychiatrist available to provide diagnostic consultation and prescribe medication.

 

Written by Megan Hebert, Ph.D., C. Psych. 

Clinical Psychologist 

MORE COMMON THAN YOU THINK  

 

There Is Hope The good news is that mental illness can be treated effectively. There are things that can be done to prevent mental illness and its impact and help improve the lives of children experiencing mental health concerns. Early intervention is best.  

 

How KIDTHINK Can Help   

To make a referral contact us   

 

For additional resources   

 

To subscribe to our newsletter click help  

 

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Centre for ADHD Awareness, Canada. (2021). Understanding ADHD. Retrieved from https://caddac.ca/adhd/understanding-adhd/in-general/facts-stats-myths/#

Centers for Disease Control and Prevention. (2021). Attention-Deficit/Hyperactivity Disorder (ADHD). Retrieved from https://www.cdc.gov/ncbddd/adhd/facts.html

Supporting Anxious Children

Anxiety is one of the most common mental health concerns for children. Worldwide prevalence rates suggest that about 6.5% of children are likely to meet diagnostic criteria for an anxiety disorder at any one time (Polanczyk et al., 2015).  Anxiety is the most common presenting concern for children seeking treatment at KIDTHINK.  While anxiety is a normal emotion that everyone experiences, for some children it becomes problematic and begins to interfere with their daily functioning, development, and ability to participate in age-appropriate activities.  This can lead to significant distress not only for children but for their parents and other family members as well.

Anxiety Treatment

The goal of treating anxiety is not to get rid of the anxiety but to help children manage it so that it does not interfere with their abilities to lead meaningful lives.  Anxiety helps us survive.  It signals to us when we are in danger, activating our nervous systems and preparing our bodies for action – to fight, flee, or freeze in the face of a real threat or danger.  However, some children have overactive alarm systems.  They tend to greatly overestimate the amount of risk involved in everyday situations and how terrible the outcomes might be (Clarke & Beck, 2011).  They also tend to underestimate their ability to cope with the outcomes and their anxious feelings (Clarke & Beck, 2011).  This results in children experiencing a strong sense of helplessness and vulnerability, setting off their fight, flight, or freeze survival responses.  

In the face of this distress, children often resort to behaviours that increase their sense of safety and security - mainly AVOIDANCE.   The problem with avoidance is that while it is helpful in the short-term in eliminating anxiety, in the long-term, it serves to maintain and reinforce more anxiety because children never get to learn that the risk wasn’t as great as they predicted or that they were, in fact, able to cope (Beck, 2011).

Parents’ natural inclination is to protect their children from distress.  Unfortunately, when it comes to anxiety, protecting children from distress by allowing them to avoid anxiety-provoking situations only serves to maintain children’s anxiety and reinforce their avoidance.  Exposing children to their fears and anxieties can seem counterintuitive and stressful for parents, but it is doing what’s best for them.  Exposure therapy is a large component of the evidence-based cognitive behaviour therapy approach that is considered best practice for treating anxiety in children (AACAP, 2007).

Strategies For Supporting Anxious Children

Settle Yourself First

Parents and caregivers use their own nervous systems to help regulate the nervous systems of their children when their children are upset – whether it’s anxiety or any other distressing emotion like anger or frustration.  In the face of heightened emotion in parents, children will have greater difficulty managing anxiety.  Parents can settle themselves by taking a moment to tune into themselves and recognize their own reactions to their children’s distress and behaviour - the unhelpful automatic thoughts that pop into their minds (i.e. “Here we go again!”), their feelings (i.e. anxiety, anger, hopelessness), physiological sensations (i.e. muscle tension), and behaviour.  

Paying attention to these domains can help parents identify what they need to settle themselves, so they are better able to respond to their children.  This may involve taking a few deep breaths, using some coping statements, or taking a brief parent time-out.  Developing these skills is hard work and takes practice.  It’s important for parents to be gentle with themselves and recognize that they are human and will not get this right 100% of the time.

Validate Feelings

Parents are often activated by their children’s distress.  This is what motivates and drives parents to protect their children from danger.  Related to this, parents often want to get rid of their children’s anxiety, and this can lead to tendencies to dismiss it or attempts to convince children out of it with statements such as, “Don’t worry,” or, “It will be fine.”  Unfortunately, this can have the opposite effect than intended and result in children feeling alone with their anxious feelings, adding to their distress.

Being emotionally present with children in their anxious feelings helps them to feel understood and supports parents in joining with them to begin settling those survival responses.  Acknowledging and validating children’s anxious feelings can help parents convey an understanding of how difficult it is for children to face their fears and worries.  This can be done without reinforcing children’s anxiety and while communicating confidence in their abilities to cope successfully with situations.

“If you think there are monsters under your bed, no wonder you are feeling scared! It makes sense that you are having such a difficult time falling asleep. Let’s figure out what we can do about this.”

Help children understand the physical symptoms of anxiety

Teaching children about what is happening in their bodies when they are anxious helps them understand that, while the physical sensations are uncomfortable, they are not dangerous.  A rapid heartbeat, increased breathing, or muscle tension are signs their bodies are doing just what they were designed to do to help protect them – gathering more oxygen and producing special fuel (cortisol, adrenaline) to give their bodies the energy needed to fight, flee, or freeze.  However, because children are not facing life-threatening danger, this is a false alarm and can become problematic.

Instead of viewing physical symptoms of anxiety as threatening, parents and caregivers can praise children for listening to their bodies and help children to view these symptoms as cues to use strategies to help calm their bodies.  Relaxation strategies such as belly breathing can be introduced to help children gain a sense of mastery over their bodies as they learn how to settle their survival responses.  Developing these skills takes time and effort.  Children will often have greater success implementing relaxation skills when they are anxious if they have had plenty of practice using the skills when they are calm and if their parents use them too.  

Encourage brave behaviour

Instead of focusing on and giving too much attention to anxious behaviours (i.e. clinging to parents, crying), parents can look for and reinforce the brave behaviours their children exhibit.  Brave behaviours include any action or step (no matter how small) children take in moving towards their unrealistic fears.  This includes effort – even if children are not successful in completing or following through with the task or step.  Providing praise and encouragement for brave behaviour can help children build greater self-confidence and begin to view themselves as brave.  This can increase their willingness to face their fears and can help them feel like they have greater control over their anxiety.  

Gradual Exposure

Gradual exposure involves helping children face their fears in a gradual way by breaking exposure tasks down into very small and manageable steps.  For children who are anxious about swimming lessons, for example, this might involve a progression from showing up to the pool, to sitting next to the water, allowing the instructor to splash some water on their legs, dipping their toes in the water etc.  Patience is critical!  The most important element is that children are active participants in the process and taking steps to move forward (no matter how small) and are building a sense of mastery and confidence.  Pushing children too quickly can overwhelm them, increase their anxiety and set them back in their progress.  It’s best for parents to take on a cheerleading role.  Celebrating all the small successes and victories is also important and a nice way for parents to reward their children (and themselves!) for all the hard work.

Coping Ahead

Helping children identify their feared outcomes provides an opportunity to help them develop a plan for coping in the event they are faced with their worst-case scenarios.  When children can identify ways to solve these problems, they are better prepared to cope, increasing their confidence and willingness to face their fears.  

 

The good news is that anxiety can be treated effectively.  It’s helpful to keep in mind, however, that progress will take time and does not happen overnight or in a linear fashion.  Setbacks are to be expected and are a natural part of recovery.  The goal is not to eliminate anxiety entirely.  The aim is to bring anxiety down to manageable levels so that children can lead meaningful and enjoyable lives. We want to help them adjust their alarm systems, so they can experience the helpful effects of anxiety, such as increased alertness and energy before a big test or presentation, without the unhelpful effects of an overactive alarm system that leads to avoidance.  Children will need ongoing support to keep practicing skills for some time before they can apply the skills with increasing independence.  

For many children, anxiety can be chronic and can resurface at different points in development or when children are faced with unusually large stressors, such as COVID-19.  Some children may require additional support from a mental health professional.  If anxiety is causing significant impairment in your child’s daily functioning, interfering with his/her ability to participate in developmentally appropriate activities, and/or causing you or your child significant distress, don’t hesitate to seek professional help.  Early intervention is best as it leads to better outcomes for children and reduces the likelihood of children suffering from additional mental health concerns.

 

Kari Deschambault MSW, RSW

Mental Health Clinician

MORE COMMON THAN YOU THINK

 

There Is Hope The good news is that mental illness can be treated effectively. There are things that can be done to prevent mental illness and its impact and help improve the lives of children experiencing mental health concerns. Early intervention is best.

How KIDTHINK Can Help 

To make a referral contact us 

For additional resources 

To subscribe to our newsletter click here.

 

References

  1. American Academy of Child and Adolescent Psychiatry (2007).  Practice Parameter of the Assessment and Treatment of Children and Adolescents with Anxiety Disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 46(2), 267-283.  Retrieved from https://www.jaacap.org/article/S0890-8567(09)61838-4/pdf. 
  2. Beck, J. (2011). Cognitive Behavior Therapy: Basics and beyond (2nd Ed). Guildford Press: New York.
  3. Clark, D.A. & Beck, A.T. (2011). Cognitive Therapy of Anxiety Disorders: Science and Practice. Guildford Press: New York.
  4. Government of Canada. (2006). The human face of mental health and mental illness in Canada. Minister of Public Works and Government Services Canada. Retrieved from https://cpa.ca/docs/File/Practice/human_face_e.pdf
  5. Polanczyk, G.V., Salum, G.A., Sugaya, L.S., Caye, A., & Rhode, L.A. (2015).  Annual Research Review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents.  Journal of Child Psychology and Psychiatry, 56, 345-365.  Retrieved from https://www.researchgate.net/publication/271842422 
  6. Virgo Mental Health and Addictions Strategy Report, Manitoba 2018. Retrieved from https://www.gov.mb.ca/health/mha/strategy.html

Depression in Children

Do children get depressed?

In short, the answer is yes. 

Approximately 10 to 20 percent of very young Canadian children have a mental health problem. We know that 70 percent of mental health problems have their onset during childhood or adolescence. We also know that mental and physical health are linked. So, if a child has a physical health problem, it is possible to develop mental health issue and vice versa. 

Mental illness is a leading cause of disability in Canada. Depression increases an individual’s risk of suicide, which is the second leading cause of death in young people (Dwyer et al., 2020). 

50 to 70 percent of children who experience depression are at risk of a recurring depression within 5 years (Dunn et al., 2006) which can result in worsening suicidality.   

Depression in children is real and needs our attention. 

 

How do I know if my child is depressed? 

Caregivers can look for signs of depression in children. Common symptoms include the following: 

Difficulty falling asleep or staying asleep resulting in sleep loss is a major predictor of depression in young Canadians (Hoyniak et al., 2020). Children with depression may also be excessively sleepy and complain of feeling tired all the time.

 

When children suddenly stop finding joy in games or play activities that were previously enjoyed, this is a red flag, especially if it isn’t related to normal developmental maturation. For example, it is normal for children to develop varying interests over time and play with new toys, leaving old ones behind. It isn’t normal for healthy children to have no interest in any activities or play. 

 

As mentioned, physical and mental health are linked. Children with depression may experience physical symptoms such as persistent headaches, vomiting or complaints of a sore stomach. A visit to a doctor can determine if the physical complaints have a medical cause or if further mental health assessment is recommended. Recent research has also discovered that a genetic link exists in children with asthma and major depression (Lui et al., 2020) meaning that if a child has asthma, it is helpful to monitor that child for depression as well since the two health issues may share the same genetic profile. 

 

When children become unusually irritable and angry or feel deeply saddened, hopeless or guilty for a prolonged period of time, it is important to explore possible factors that are contributing to this change in mood. If teachers and caregivers are noticing negative moods for more than 2 weeks, it is worth further investigation. 

 

Children with depression typically struggle with completing tasks either at home or at school due to the impact that depression has on thinking and memory. If a child is suddenly receiving poorer grades in school or is consistently forgetting to do normal everyday tasks, it is cause for concern. 

 

Some healthy children are naturally shy or hesitant to interact with others and may eventually ‘come out of their shell.’ In 2020, Statistics Canada reported that 25 percent of children (aged 5 to 17) with poor mental health are more likely to have difficulty making friends. If a child begins refusing to spend time with family or friends and prefers to be alone, it may be a sign of deteriorating mental health. 

 

If a child suddenly experiences an increase or decrease in appetite not related to a growth spurt, it is worth monitoring. Children can seek food for comfort or can refuse to eat when dealing with a mental health problem. Sudden weight gain or weight loss may be a red flag and should be investigated further to determine the cause.

 

Anxiety and depression are common co-existing mental health problems. When a child becomes more clingy or anxious with caregivers or seems to have separation anxiety during normal everyday activities (for example, drop-offs at daycare or school or crying at bedtime), it may be an early warning sign of a mental health issue. 

 

Statements made by children such as “I wish I wasn’t alive” or “I don’t want to be in this world” or “I’m going to kill myself” are serious and require immediate attention from caregivers. If a child is focusing on themes of death (either in what the child talks about or expresses through drawings), the caregiver(s) should immediately contact the pediatrician or family doctor for further evaluation. 

 

What causes depression in children?

Depression is a result of a combination of many factors including genetics, life events, environmental influences, physical/mental health and family history.  

1) Genetics

Depression is a highly heritable disorder. This means that if a child has a parent with depression, the child has a higher chance of developing depression than a child whose parent has never had depression. 

 

2) Adverse Life Events

Children who have been victims of bullying, maltreatment, deprivation or trauma are at higher risk of developing depression in their lifetime (Elmore et al., 2020). 

 

3) Environmental Influences and Family History

Children brought up in homes wherein the parenting style is harsh, including highly controlling/low warmth may contribute to the development of depression. Research shows a moderate association between an insecure attachment (to a parent/caregiver) and depression in children and adolescents (Spruit et al., 2019). Where there is a family history of violence, alcohol abuse or physical/sexual abuse or immigration the risk of depression increases for the child. 

 

4) Physical and other mental health concerns

Children with various physical health problems or pre-existing mental health conditions such as Attention-Deficit/-Hyperactivity Disorder (ADHD), Conduct Disorder and Obsessive-Compulsive Disorder (OCD) are at higher risk of developing depression. 

 

Are there any protective factors that may reduce the risk of depression in children?

 

Having a secure attachment to a caregiver, positive childhood experiences, learning how to become resilient in the face of challenges or adversity, participating in physical activity and sports (Matta et al., 2021), maintaining healthy sleep routines and meaningful connections to peers are factors that can protect a child from the onset of depression. 

 

What do I do if I suspect my child is depressed and how is it diagnosed?

If you suspect your child is depressed, take him/her to a pediatrician or primary care physician to have a full medical assessment, to rule out any physical health problems. Caregivers may be asked to fill out questionnaires that review symptoms seen in the child.  Children may also have other issues such as anxiety, ADHD or eating disorders that can be related to depression. The physician can then decide if a referral is needed for further assessment by a mental health professional.

 

What is the treatment for depression in children and is it even necessary? 

Research shows that the best treatment for depression includes a combination of medication and cognitive behavioural therapy and these may be associated with lower rates of relapse (Viswanathan et al., 2020). The type of treatment your child may receive for depression may include a combination of therapies and medication depending on the child’s age, communication skills and intellectual abilities. 

Individual treatment may include play therapy (for younger children), resilience-oriented cognitive behavioural therapy (talk therapy for older children) and learning strategies to recognize and cope with big emotions.  

Family therapy may also be beneficial in coaching parents to learn healthy responses to a child’s emotions (Luby et al., 2020), improve family communication, and learn strategies for self-regulation. 

After careful assessment and discussion with your child’s doctor and/or mental health team, your child may be prescribed medications to treat the depression. Many parents are fearful of giving their children medications and this is a decision that is best made in collaboration with mental health professionals.  Parents and caregivers can learn about the risks and benefits of specific medications by talking to the doctors or professionals and asking questions. It may take a few weeks to notice a difference in the child’s emotions after starting an antidepressant and this is to be expected.  Sometimes it takes a trial of a few different medications to find the right one for your child. Caregivers need to be able to monitor the child to observe how the child is tolerating any medication and to provide feedback to the doctor on a regular basis. This can help the doctor in determining the right dose of medication for the child. It is very important that the child take the medication at the same time every day. Sometimes this means that schools become involved in supporting the child if a medication is needed during the school day. Caregivers need to be aware of the dangers of stopping a medication abruptly and any changes to medications should be in consultation with the child’s doctor. 

When mental health issues are left untreated, the risk of long-term disability increases.  Results from the new Canadian Health Survey on Children and Youth (CHSCY) indicate that 4% of children and youth aged 1 to 17, as reported by their parents, had fair or poor mental health in 2019, one year prior to the pandemic. The survey also found that poor mental health among children and youth was associated with adverse health and social outcomes, such as lower grades and difficulty making friends. (Statistics Canada, 2020). 

It is essential that any child who has suffered a depression be monitored regularly over time, especially during adolescence and when transitioning into adulthood. Monitoring the individual over his/her youth and adolescence is a proactive way to treat symptoms early which can prevent further illness or disability (Asarnow et al., 2019).  

 

How can KIDTHINK help? 

KIDTHINK is a multi-disciplinary child mental health centre in Winnipeg, Manitoba who supports the mental health of children under the age of 12 years and their families. We offer mental health assessments to diagnose depression in children and provide a wide range of therapies to treat depression. 

Caregivers are invited to contact KIDTHINK’s Information Line at (431) 388-5373 to speak with an Intake Coordinator and to schedule an assessment with a mental health professional. For more information, please visit our webpage at www.kidthink.ca

 

Written by Tamara Rogers, MSc., BMR (OT), OT Reg. (MB)

Outreach Clinician 

 

MORE COMMON THAN YOU THINK  

 

There Is Hope The good news is that mental illness can be treated effectively. There are things that can be done to prevent mental illness and its impact and help improve the lives of children experiencing mental health concerns. Early intervention is best.  

 

How KIDTHINK Can Help   

To make a referral contact us   

For additional resources   

To subscribe to our newsletter click help  

 

 

RESOURCES

Read about the Mental Health Commission of Canada’s Supporting Early Childhood Mental Health by clicking on this link: https://www.mentalhealthcommission.ca/sites/default/files/2020-07/early_childhood_one_pager_eng.pdf

Read about the Mental Health Commission of Canada’s Early Childhood Mental Health: ‘What We Heard’ Report Summary by clicking on this link: https://www.mentalhealthcommission.ca/sites/default/files/2020-11/ECMH_What_We_Heard_Report_eng_0.pdf

Download this app to help cope with the stresses of life: http://calminthestormapp.com/

 

REFERENCES 

Asarnow, J., Tompson, M., Klomhaus, A., Babeva, K., Langer, D. and Sugar, C. (2019). Randomized control trial of family-focused treatment for child depression compared to individual psychotherapy: one-year outcomes. The Journal of Child Psychology and Psychiatry, 61(6):662-671. https://doi.org/10.1111/jcpp.13162

Dunn, V., Goodyer, IA. (2006). Longitudinal investigation into childhood and adolescent-onset depression. British Journal of Psychiatry, 188:216-222.

Dwyer, J., Stringaris, A., Brent, D. and Bloch, M. (2020). Annual research review: defining and treating pediatric treatment resistant depression. The Journal of Child Psychology and Psychiatry, 61(3): 312-332. https://doi.org/10.1111/jcpp.13202

 

Government of Canada (2006). The human face of mental health and mental illness in Canada. Ottawa: Minister of Public Works and Government Services Canada. 

Elmore, A., Crouch, E. and Chowdhury, M. (2020). The interaction of adverse childhood experiences and resiliency on the outcome of depression among children and youth, 8-17 year olds. Child Abuse & Neglect, Volume 107, 104616, ISSN 0145-2134. https://doi.org/10.1016/j.chiabu.2020.104616

Hoyniak, C.P., Whalen, D.J., Barch, D. et al. Sleep problems in preschool-onset major depressive disorder: the effect of treatment with parent–child interaction therapy-emotion development. Eur Child Adolesc Psychiatry (2020). https://doi.org/10.1007/s00787-020-01641-1

 

Luby, J., Gilbert, K., Whalen, D., Tillman, R., and Barch, D. (2020). The differential contribution of the components of parent-child interaction therapy emotion development for treatment of preschool depression. Journal of the American Academy of Child & Adolescent Psychiatry, 59(7):868-879.ISSN 0890-8567.https://doi.org/10.1016/j.jaac.2019.07.937

Lui, X., Munk-Olsen, T., Albiñana, C., Vilhjálmsson, B., Pedersen, E., Schlünssen, V., Bækvad-Hansen, M., Bybjerg-Grauholm, J., Nordentoft, M., Børglum, A., Werge, T., Hougaard, D.,Mortensen, P. and Agerbo, E. (2020). Genetic liability to major depression and risk of childhood asthma. Brain, Behavior, and Immunity, 89:433-439. ISSN 0889-1591. https://doi.org/10.1016/j.bbi.2020.07.030

Matta, P., Baul, T., Loubeau, K., Sikov, J., Plasencia, N., Sun, Y. and Spencer, A. (2021). Low sports participation is associated with withdrawn and depressed symptoms in urban, school-age children. Journal of Affective Disorders, 280(B):24-29. ISSN 0165-0327. https://doi.org/10.1016/j.jad.2020.11.076

Spruit, A., Goos, L., Weenink, N. et al. (2020) The Relation Between Attachment and Depression in Children and Adolescents: A Multilevel Meta-Analysis. Clin Child Fam Psychol Rev 23, 54–69. https://doi.org/10.1007/s10567-019-00299-9

Statistics Canada: Canadian Health Survey on Children and Youth, 2019 Released at 8:30 a.m. Eastern time in The Daily, Thursday, July 23, 2020 https://www150.statcan.gc.ca/n1/daily-quotidien/200723/dq200723a-eng.htm

Viswanathan M, Kennedy SM, McKeeman J, et al. (2020). Treatment of Depression in Children and Adolescents: A Systematic Review [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US). (Comparative Effectiveness Review, No. 224.) https://www.ncbi.nlm.nih.gov/books/NBK555853/

Waddell et al. (2005). A public health strategy to improve the mental health of Canadian children. Canadian Journal of Psychiatry, 50:226-233. 

 

Celebrating During a Pandemic?

It is that time of year where many of us are preparing to celebrate various religious and cultural holidays.  This year, part of the preparation will involve thinking about how we will celebrate during a global pandemic with our need to physically distance.  While holidays can be sources of stress during a normal year, due to things like pressure to purchase gifts and create memories for others, remembrance of loved ones lost, and complicated family relationships, we may experience many additional challenges this year.  These could include things like not being able to physically be with the ones we care about and not being able to engage in some important and meaningful traditions.  

Because of these and other added challenges, we wanted to provide you with some hope and ideas about making the best out of this difficult situation; finding some joy and fun and minimizing the effects of stress on ourselves during the upcoming holidays.  

It’s Okay to Feel Sad

If there are important events we cannot do this year or people we cannot see, it is okay to feel disappointed and sad about this.  These are real losses, though they may feel small in comparison to other losses.  2020 has been a year of small and large losses for almost everyone and making space for all feelings is important for good mental health, though it does not feel pleasant.  Acknowledging difficult feelings and giving yourself compassion for these little and large hurts is important for mental well-being and allows us to move through them more effectively than denying them (For more on the importance of self-compassion see Drs. Kristin Neff and Christopher Germer, e.g., Germer, 2009). 

We, as parents or caregivers, will feel these losses and so will our children.  It is important that we make space for our children to have these feelings too.  While this can be difficult for us, as we do not want our children to experience painful emotions, it’s very important for us to do so for their mental health.  Some important ways to support our children with difficult emotions are to help them name the emotions, provide empathy for the feelings, and help our children find healthy ways to cope with them.  (For more on this, watch our free on-demand webinars called Parenting in Times of Uncertainty and Managing Back-to-School Anxiety During COVID-19, which can be found on the Events page of our website).

Shift our Expectations

Sometimes our level of stress or dissatisfaction around holiday events is related more to what we think a “good” holiday should involve rather than appreciating what is present.  These “should’s” or expectations come from many places including comparing ourselves with others, popular media messages, the culture around us, our family and friends, and our past experiences.  Checking, changing, or reducing our expectations, will be particularly important this year as so many things need to change for us to celebrate safely. 

Once we have given space for feelings of sadness and disappointment, we can take a closer look at what we expect of our holidays, ourselves, and those around us.  Are those realistic this year?  Are we being perfectionistic or rigid in our expectations?  How can we make meaning and joy in new, creative and safe ways this year? Related to this is recognizing that events will never go exactly as planned.  Mistakes will be made.  Plans will go array.  The zoom call may freeze.  Accepting these “bumps in the road” is another way we can be realistic with ourselves and those around us.  Knowing this, we can approach our holiday events and those around us with some flexibility, grace, and a sense of humour.  Sometimes the biggest mistakes become the best holiday memories and even lead to new traditions.  This flexible attitude can also help us to focus on and appreciate what went well rather than what went wrong; reducing our stress level and increasing our joy.  (For more on the benefits of psychological flexibility see Kashdan & Rottenberg, 2010.)

More is Not Always Better

In normal years, holiday stress is often connected to the pressure to do more, to go big.  However, the more activities, events, and tasks we add to our lists, the greater the stress and the greater the chance for overwhelm.  More is not always better when it robs us of our joy and the purpose and meaning behind the celebration.  Maybe the silver lining for this year is that the reduced number of events, activities, and obligations can lead to a reduction in stress.  

It is also important to remember that, “more is not always better,” also applies to gift giving.  It can be helpful to remember how quickly children get tired of their toys and what long-term memories are really made of – time together, relaxed (not stressed out) parents and caregivers, family and friends, and unexpected moments that can’t be planned.  When planning gift giving, it is also important to be aware of our financial situation, which may be much different this year.  The short-term reward of smiling faces and impressing with gifts should be balanced against our ability to afford the gifts and potential financial burden and stress that may result.  In a study measuring what behaviours or situations contribute to people feeling loved, participants ranked human interaction, like a kind word, cuddling a child, and receiving compassion, as more significant expressions of love than receiving material items (Heshmati et al., 2017).  It can also be helpful to keep in mind what the holidays mean for us spiritually, culturally, or personally and focus our time and energy on those things rather than presents.  This leads to the next tip.

Include Meaningful, Fun and Rejuvenating Activities

Find Ways to Give to Others

One way we might include something meaningful during our holiday time is to find ways to give to others.  Research shows that doing something kind for ourselves improves our mood and general well-being (e.g., Kahana et al., 2013).  It helps others and us!  Giving back to others helps us feel good, improves our community, and adds to the meaning of the holiday spirit.  Again, the tips above still apply.  We should do this in a way that works for us and our level of stress.  This year, we also need to keep in mind the need to physically distancing and abide by other safety guidelines.  Simple things like making a phone or video call or sending a card can mean a lot to someone.  Maybe making donations instead of buying presents could be an option for some families.  Giving to others during the holiday season can give us ideas and motivation to consider giving back to others throughout the year.  This year it is increasingly important that we take care of each other, and the benefits to us and others remain no matter when we give.

Another way we can give back to others during the holiday season is to include and be sensitive to others’ situations.  For example, others may not celebrate the same holidays we do and may feel left out or feel their holidays are minimized in comparison.  Obviously, this applies particularly to those of us in the dominant culture.  While we certainly can feel the freedom to celebrate our holidays, we can do so with grace, kindness, and sensitivity.  Learning about and appreciating other’s holidays, that we may not celebrate, is an important way to build and create community and a sense of unity.

Another situation that requires sensitivity is for those for whom the holiday time is very difficult.  This may be due to a sense of loneliness, grief, remembrance of loved ones lost, or other reasons.  Holidays can evoke a lot of mixed feelings for people.  Making sure we do not expect everyone to feel happy or the way we do is a way we can be sensitive and give back to others.  Listening to and allowing those around us to have their unique experiences is a wonderful gift.

Balance. Joy. Meaning. Fun. Rest. Family. Friends. Community. Love.  These are what holidays were meant for.  We encourage you to take the time to foster these things in a reasonable, safe, and flexible way for you and those around you.  Whatever holiday you celebrate, we wish you all of these things and more.

Written by Jo Ann Unger, PhD., C. Psych.

 

MORE COMMON THAN YOU THINK 

There Is Hope The good news is that mental illness can be treated effectively. There are things that can be done to prevent mental illness and its impact and help improve the lives of children experiencing mental health concerns. Early intervention is best. 

How KIDTHINK Can Help  

To make a referral contact us 

For additional resources 

To subscribe to our newsletter click here

References

Chiesa, A. & Serretti, A. (2009).  Mindfulness-based stress reduction for stress management in health people: A review and meta-analysis. The Journal of Alternative and Complementary Medicine, 15(5)., 593-600.  https://doi.org/10.1089/acm.2008.0495 

Dozois, D. J. A., & Mental Health Research Canada. (2020). Anxiety and depression in Canada during the COVID-19 pandemic: A national survey. Canadian Psychology/Psychologie canadienne. Advance online publication. http://dx.doi.org/10.1037/cap0000251 

Germer, C. K. (2009). The mindful path to self-compassion: Freeing yourself from destructive thoughts and emotions. New York: Guilford Press.

Heshmati, S., Oravecz, Z., Pressman, S., Batchelder, W.H., Muth, C., Vandekerckhove, J. (2017). What does it mean to feel loved: Cultrual consensus and individual differences in felt love. Journal of Social and Personal Relationships, 36(1), 214-243. https://doi.org/10.1177%2F0265407517724600 

Ho, M.Y., Cheung, F.M., & Cheung, S.F. (2010).  The role of meaning in life and optimism in promoting well-being.  Personality and Individual Difference, 48(5), 658-663. https://doi.org/10.1016/j.paid.2010.01.008 

Kahana, E., Bhatta, T., Lovegreen, L. D., Kahana, B., & Midlarsky, E. (2013). Altruism, helping, and volunteering: pathways to well-being in late life. Journal of aging and health, 25(1), 159–187. https://doi.org/10.1177/0898264312469665 

Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical psychology review, 30(7), 865–878. https://doi.org/10.1016/j.cpr.2010.03.001 

Lin, C. (2017). The effect of higher-order gratitude on mental well-being: Beyond personality and unifactoral gratitude. Current Psychology, 36, 127-135. https://doi.org/10.1007/s12144-015-9392-0 

Pressman, S. D., Matthews, K. A., Cohen, S., Martire, L. M., Scheier, M., Baum, A., & Schulz, R. (2009). Association of enjoyable leisure activities with psychological and physical well-being. Psychosomatic medicine, 71(7), 725–732. https://doi.org/10.1097/PSY.0b013e3181ad7978 

 

Disruptive Behaviour Problems: What Is Going On and How Can We Help?

Children with disruptive behaviour problems are typically described as irritable, angry, uncooperative, argumentative, delinquent, aggressive, and disobedient. They are often butting heads or in conflict with parents, teachers, family members, peers, and other authority members, which can take a real toll on family relationships, friendships, learning, and overall quality of life. They are often mislabeled as “trouble-makers” or “bad kids” who are frequently sent home from school, not invited to birthday parties, or kicked off sports teams.

Many people often do not see beyond the children’s difficult behaviours, and these exclusions affect them and can lead to additional mental health struggles like low self-worth. Although it is challenging not to focus on the problematic behaviours, when dealing with these children, it is key to understand that they have poor emotional and behavioural regulation and have developed maladaptive coping and problem-solving strategies. The good news is that despite their ongoing challenges, there are ways to improve their behaviour and prevent things from getting worse. 

What are Disruptive Behavioural Problems?

Although it is typical for all children to act-out, throw tantrums, and be oppositional and defiant from time-to-time, some children experience disruptive behaviour problems that are more than expected for their developmental age, gender, or culture. Some children with an ongoing pattern of behavioural issues may even be diagnosed with a behavioural disorder such as oppositional defiant disorder (ODD). The American Psychiatric Association defines ODD as a frequent and ongoing pattern of angry/irritable mood, argumentative/defiant behaviour, or vindictiveness (2013). Children with ODD often lose their temper, “dig in their heels” when asked to do something, blame others when they get into trouble, feel like they need to “get back” at someone when they have been wronged, or appear to be "lawyers-in-the-making" due to their constant arguing. Unfortunately, excessive and persistent disruptive behavioural difficulties in children, especially those diagnosed with ODD, typically do not resolve on their own nor are they “just a phase”. Rather, these children are at-risk for negative outcomes later in life such as anxiety and depressive disorders, violence, substance abuse, unemployment, and delinquency.

ODD also often precedes the more serious diagnosis of conduct disorder which includes symptoms such as physical aggression towards animals and people, destruction of property, and a pattern of deceit (American Psychiatric Association, 2013). Furthermore, not only do these behavioural challenges create and predict negative outcomes for the children themselves, but they also create significant ongoing stress for others within the child’s life and have negative economic impacts on society (Child Development Institute, 2016). Therefore, it very important to provide support and treatment to these children and their families as soon as possible. This can help to reduce future negative outcomes and encourage more positive outcomes. 

There is Help

Fortunately, there have been many treatment approaches developed to help children better regulate their emotions, control their behaviour and learn more adaptive coping and problem-solving strategies. And research shows that these treatments can be effective in reducing behaviour challenges and preventing long-term negative impacts, especially when addressed early.

One such treatment approach for behavioural issues is cognitive behavioural therapy (CBT). CBT interventions typically focus on reducing disruptive behaviours, empowering children to problem solve, and use more appropriate and adaptive strategies. Children learn how their thoughts and feelings affect their actions and behaviour. They learn to be in control of their actions, challenge unhelpful thoughts, soothe their own emotions, and learn strategies to better deal with problems. Involving parents and caregivers to learn the best-practices of supporting children with behavioural issues has also been shown to help children with these challenges. (Dumas, 1989; Sukhodolsky et al., 2016). 

SNAP 

At KIDTHINK, we are excited to be the first in Manitoba to offer the evidence-based mental health program SNAP to help children ages 6-11 who are experiencing disruptive behaviour difficulties, as well as their families. SNAP, which stands for Stop Now And Plan, was developed by the Child Development Institute and is an award-winning, internationally recognized program. SNAP uses a CBT-theoretical model with parental involvement and is gender-sensitive. Over 13 weeks, the program teaches children with behavioural issues, and their parents, effective emotional regulation, self-control, and problem-solving skills using a structured and strength-based approach.

In studies, SNAP has been shown to have many positive outcomes for children including reducing aggressive, rule-breaking, and conduct behaviour and increasing prosocial communication and emotional regulation skills. Many long-term outcomes have also been shown, such as less school dropout, less involvement in criminal activities, more positive relationships, and fewer mental health disorders (Augimeri, Farrington, Koegle, et al., 2007; Burke & Loeber, 2015, 2016). Additionally, parents report positive benefits such as feeling more confident in their parenting, having peer supports and connecting more with their families (Lipman et al., 2011). SNAP helps children and their families grow and learn together to build a healthier and happier family life. 

We hope to run one 10-11-year-old boy’s group and one 10-11-year-old girl’s group, with accompanying caregiver/parent groups, in early 2021.  Due to generous funders, these groups will be offered free-of-charge. We also have the ability to provide the SNAP program virtually should that be needed for health and safety reasons. If you think you and your family could benefit from SNAP, please contact KIDTHINK to learn more and to self-refer.  Intake assessments, to see if this program is the right for your family, will be completed this fall.  Space is limited. 

 

To learn more about SNAP, please go to their website https://childdevelop.ca/snap/ 

 

Written by Megan Hebert, Ph.D., R. Psych. (AB)

 

Thank you for supporting the SNAP program in Manitoba

MORE COMMON THAN YOU THINK 

There Is Hope The good news is that mental illness can be treated effectively. There are things that can be done to prevent mental illness and its impact and help improve the lives of children experiencing mental health concerns. Early intervention is best. 

How KIDTHINK Can Help  

To make a referral contact us  

For additional resources  

To subscribe to our newsletter click help 

References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author. 

Augimeri, L.K., Fariington, D.P., Koegl, C.J., & Day, D.M. (2007) The under 12 outreach project: Effects of a community-based program for children with conduct problems. Journal of Child and Family Studies, 16, 799-807. Published Online, January 10, 2007. DOI: 10.1007/s10826-006-9126-x

Burke, J., & Loeber, R. (2015). The effectiveness of the Stop Now and Plan (SNAP) Program for boys at risk for violence and delinquency. Prevention Science, 16 (2): 242-253. DOI 10.1007/311121-014-0490-2

Burke, J., & Loeber, R. (2016). Mechanisms of behavioral and affective treatment outcomes in a cognitive behavioral intervention for boys. Journal of Abnormal Child Psychology, 44(1): 179-189. DOI: 10.1007/s10802-015-9975-0

Chartier, M., Brownell, M., MacWilliam, L., Valdivia, J., Nie, Y., et al. (2016). The mental health of Manitoba’s children. Winnipeg, MB. Manitoba for Health Policy. 

Child Development Institute. (2016). About SNAP. Retrieved from https://childdevelop.ca/snap/about-snap

Dumas, J. E. (1989). Treating antisocial behaviour in children: Child and family approaches. Clinical Psychology Review, 9. DOI: 10.1016/0272-7358(89)90028-7

Government of Canada. (2006). The human face of mental health and mental illness in Canada. Minister of Public Works and Government Services Canada. Retrieved from https://cpa.ca/docs/File/Practice/human_face_e.pdf 

Lipman, E. L., Kenny, M., Brennan, E., O’Grady, S., & Augimeri, L. (2011). Helping boys at-risk of criminal activity: Qualitative results of a multicomponent intervention. BMC Public Health, 11, 364. DOI:  10.1186/1471-2458-11-364

Sukhodolsky, D. G., Smith, S. D., McCauley, S. A., Ibrahim, K., & Piasecka, J. B. (2016). Behavioral interventions for anger, irritability, and aggression in children and adolescents. Journal of Child and Adolescent Psychopharmacology, 26(1), 58–64. DOI: 10.1089/cap.2015.0120

Accepting A Child's Diagnosis

Receiving a diagnosis of a mental illness or disorder for a child can trigger a range of reactions from parents and caregivers.  For some, this feedback brings relief, clarity, or confirmation of what they already suspected.  For others, it brings devastation, fear, guilt, shame and even denial.  While learning to accept and adjust to this new reality can be difficult, take time and is not always a linear process, it can also be a new beginning for children and families – one where the adults, equipped with a better understanding of their children’s needs, can provide children with the support they need for recovery or to improve functioning. 

Making Room For Grief & Loss

Regardless of whether a diagnosis is welcomed or not by caregivers, some sense of grief and loss is commonly experienced.  All parents and caregivers have hopes and dreams for their children and hold a vision of what the future might hold for them, which typically does not include an illness or disability.  Receiving a diagnosis can be experienced as a loss of these hopes and dreams.  Left with uncertainty and questions about how a diagnosis might impact or limit children can lead to significant worry and fear.  It’s important to make space for difficult feelings and for parents and caregivers to give themselves permission to grieve the losses – big or small.  Acknowledging these and naming them are important parts of processing these emotional experiences that are very real and steps that are often needed before parents and caregivers can accept and adjust to a new way of seeing or understanding their children.

Embracing The Opportunities That Come With Acceptance

While acceptance of a diagnosis can be difficult and take time, it creates choices and opportunities to forge a new way forward.  A diagnosis can put a name to what’s been hidden in plain sight and provide a map that helps guide a family’s next steps, helps clarify treatment needs, and gives parents a framework for better understanding their children’s strengths, needs, and difficulties.  

Enhanced Parent-Child Attunement

When parents have a better understanding of what’s contributing to their children’s distress and/or challenging (and often frustrating) behaviours, it supports greater attunement to children’s underlying needs which helps to improve parent-child relationships.  A better understanding of children’s functioning can help parents not to take their children’s behaviour personally and experience more moments where they are able to look at their children with joy and wonderment instead of frustration.   

Accessing More Effective Parent Strategies

Parents and caregivers often feel more effective and confident in responding to their children’s needs when they are equipped with appropriate strategies and understand the rationale behind these strategies.  This, in turn, helps children to feel understood and increases their receptiveness to parent support.  Understanding children’s challenging behaviours in the context of their diagnoses can also help parents maintain greater empathy for their children in high-stress parenting moments.  This can help parents settle their own unhelpful reactions that get triggered placing them in a better position to respond to their children’s needs with greater confidence and calm. 

Empowered Advocacy

A diagnosis can empower parents and caregivers to advocate for their children’s needs across environments, including schools and community activities.  It can support them in educating teachers, coaches, and other adults in their children’s support networks and advocate for any necessary accommodations or supports needed to facilitate greater success for their children in different environments.  When children experience success, it helps them recognize their strengths and enhances their sense of mastery which supports the development of a positive sense of self.  

Unexpected Gifts

Through struggle comes growth.  There are often unexpected gifts that come from parenting children living with or recovering from a mental illness or disorder.  These can be honoured without minimizing the hardships of this parenting journey.   The challenges involved can build resilience and strength.  They can also lead to increased compassion, grace, and empathy for others, among other unexpected gifts.

Building A Community Of Support

Parenting is often viewed more as an individual responsibility rather than a collective responsibility in North America compared to other cultures.  This can lead parents and caregivers to feel isolated and unsupported, especially those parenting children living with a mental illness or disorder.  Accepting a child’s diagnosis is only the first step in what is often a challenging parenting journey.  Helping children to accept and understand their diagnoses and cope with stigma are among some of the additional parenting responsibilities caregivers are faced with.  

It takes a village to raise a child – African Proverb

Building a community of support can help reduce parents’ sense of isolation and help parents and caregivers maintain their own mental health while supporting the mental health needs of their children.  A diagnosis can help parents seek out different sources of support to build their support networks.  This can include professional support from doctors and mental health professionals, natural supports from family and friends, and support from other parents with similar parenting journeys via parent support groups.     

A diagnosis doesn’t necessarily mean the journey will be any easier.  However, it can help children and families move from significant struggle and distress to greater clarity, understanding, and hope when they are equipped with new skills and tools that support positive mental health for both children and parents and the ability for children to flourish despite living with mental illness or disability.  And you don’t have to walk the journey alone.  KIDTHINK is available to help.

 

Written by Kari Deschambault MSW, RSW

Mental Health Clinician

 

Related Articles

Caregivers’ Mental Health Matters 

Indicators for Children’s Mental Health Concerns

 

MORE COMMON THAN YOU THINK

There Is Hope The good news is that mental illness can be treated effectively. There are things that can be done to prevent mental illness and its impact and help improve the lives of children experiencing mental health concerns. Early intervention is best.

How KIDTHINK Can Help 

To make a referral contact us 

For additional resources 

To subscribe to our newsletter click here

References

Chartier M, Brownell M, MacWilliam L, Valdivia J, Nie Y, et al. (2016). The mental health of Manitoba’s children. Winnipeg, MB. Manitoba Centre for Health Policy.

Government of Canada. (2006). The human face of mental health and mental illness in Canada. Minister of Public Works and Government Services Canada. Retrieved from https://cpa.ca/docs/File/Practice/human_face_e.pdf